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M$1 April 19, 2009 08:06 AM

Why does insurance cover Viagra but not birth control pills?

And pills is not all they cover for erectile dysfunction. Apparently certain penis pumps are covered too. So what is the rationale behind aiding men have sex (ED won't kill you) but not caring about women's health? Mind that birth control pills are not only for preventing pregnancy but are treatment for actual medical conditions like polycystic ovaries.
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April 19, 2009 08:24 PM
The short answer is age. Viagra is for older people who likely will only be using it for a short period of time before they die or stop being sexually active. Birth control is for women of child-bearing age. Assuming a girl starts birth control at 18, she may be on it for 20 years or more. Over time it costs much more to pay for birth control.

Another reason is that younger women have lower insurance premiums due to general good health. Older folks on the other hand will pay much more for health insurance, further offsetting the cost of Viagra.


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April 19, 2009 10:22 PM
That sounds like exactly the type of explanation an insurer would argue in court! While sexism is the obvious answer and quite possibly the underlying reason for the original decision to not cover contraception, a likely modern explanation is cost. I hadn't thought about this at all. It's a perfectly rational explanation that leads to an absurd result.

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April 23, 2009 02:58 PM - New Source
Just to add to this. Most insurance do not pay for birth control pills but WILL pay for IUD, shots, and tying of tubes. This is because these are longer term solutions. Also they will pay for birth control pills as a solution to other problems, for instance extreme crapping during periods or irregular periods. So I think even though I don't always agree with insurance agencies they are protecting their clientele. If they had to pay for all of those pills they would have to raise everyone's rates considerably; however, if they can force them into longer term cheaper solutions they can maintain there lower rates and costs to themselves.

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April 19, 2009 08:33 AM
does it really? weird ...

maybe, because the medical community finds all kinds of linked benefits to male sexual activity.

according to studies, regular sex in guys boosts immunity, reduces stress, and lessens aggression.

so writing a presecription for Viagra is indirectly writing a prescription for a dude to be healthier.

here's a lil' something from WebMD ...
http://www.webmd.com/sex-relationships/features/10-surprising-health-benefits-of-sex

... and something else via a random Cuil search ...
http://www.4-men.org/sexual-health/benefits-of-orgasm.html

conversely, the birth control pill offers a host of odd side effects, like acne, decreased sex drive, and a host of hypersensitivity.

here ...
http://women.emedtv.com/birth-control-pills/side-effects-of-birth-control-pills.html

... and here ...
http://www.medicinenet.com/oral_contraceptives_birth_control_pills/article.htm

and if we want to wax social morees/double-standards, we can attribute it to society's acceptance of male promiscuity as being, "oh, that's just what guys do!" where similar behavior in females is considered unsavory.

...

note that i'm not advocating any rationale. i'm just projecting what might be an explanation ...
Source(s):
included above ...


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April 19, 2009 08:51 AM
There is a disparity between coverage for other medications and coverage for contraception http://www.plannedparenthood.org/issues-action/birth-control/insurance-coverage-birth-control-21018.htm

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April 19, 2009 02:49 PM
good link. i didn't know that about Fed employees.

i'm wondering if the insurance denials are quagmired in some kind of "moral ground," too. as @interzone points out, latent sexism seeps into all kinds of stuff; birth control not being covered might have roots in pushing abstinence.

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April 19, 2009 06:35 PM
Oh it's definitely moral/sexist because from an economics standpoint, birth control pills are cheaper than pregnancies. Covering a pregnancy is extremely expensive. Or maybe it's not considred medical. Until recently mental health was not covered under many insurance plans.

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April 19, 2009 06:46 PM
Anyway I have to note something about your answer. You say that maybe they are concerned about the side effects of BC but Viagra can actually make a man healthier. Viagra can kill you from a heart attack. The side effects are ridiculous. If insurers were "concerned" about side effects they wouldn't cover any drugs at all.
And the side effects of birth control pills aren't that odd. They are just hormonal side effects, some are serious but most are just annoying. The most dangerous one is the risk of stroke but it's gone down as estrogen dosage has gone down.

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April 19, 2009 10:01 PM
@dumblonde ... oh heavens, i agree in spades.

i didn't mean that Viagra makes a guy healthier; i meant that maybe the over-oppressive, male-centric system deems sex for guys is healthy. so whatever they can do to propagate those means is thereby ... healthy. 'ish.

i also just wanted to be clear that my answer is a shot at "their" explanation ... and by no means MY answer. i'm trying to put words in their mouth, because i personally feel that the gaping whole in medical coverage, I.E. birth control, is asinine.

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April 19, 2009 10:46 PM
I understand. I just don't think the arguments you said would be used by insurance companies in real life. I don't think they think that way.
But thanks for trying anyway. It just wasn't the type of answer I was looking for.

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April 19, 2009 11:29 PM
where, in any part of your question, does it mention what insurance companies would argue? were you looking for legal arguments?

that was a touch unclear ...

good luck with the answer, and apologies that my interpretation wasn't your cup 'o tea.

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April 20, 2009 12:45 AM
Ok. you're right.

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April 19, 2009 11:14 AM
I think that's because this is still deeply patriarchal, male dominated world.

Even in a country like the Netherlands, a model liberal society, women are often paid 10% less, on average, than their male counterparts doing the same job. This is achieved by adding virtual, non-existent "tasks" to man's job description. Sad, but true.

Source(s):
http://www.randomhouse.com/pantheon/paglia/world.html


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April 19, 2009 06:29 PM
Yeah :-( Here in the US the pay gap is larger, I think something like 25%.

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April 19, 2009 07:03 PM
Right... So many years into post-feminist era, and it's still a major event when a woman takes up a position, a high political office, or a prominent place in business world... It should be a norm by now, this is 21st century, we are so post-everything and totally cool... or, are we..?

I think women should focus on media instead of politics & biz, more initiatives like The Huffington Post.

http://www.huffingtonpost.com

http://en.wikipedia.org/wiki/Arianna_Huffington
http://blog.clickz.com/arianna_huffington.jpg

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April 19, 2009 10:32 PM
Why should women focus on one thing like media versus another? I think women should do whatever they feel like doing. I want to be a lawyer and the pay gap and glass ceiling keeping women from becoming partners in major law firms shouldn't keep me from pursuing what I want to do.

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April 19, 2009 10:52 PM
Of course, a woman should pursue any career she wants to!

What I meant is that there is more power in media than in politics when it comes to influencing people's opinions and changing deeply rooted prejudices, breaking taboos, etc.

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April 19, 2009 11:22 PM
True. Huffington is amazing! But lawyers (lol need to defend myself) can change a lot too especially from a judge's bench.

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April 20, 2009 10:00 AM
Agree! Go for it!

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April 19, 2009 08:31 PM
In my knee jerk opinion, it is a purely sexist situation. However, after some thought and research I realize that there is a religious bias to the problem too. The Catholic church considers contraceptive birth control immoral. Although there are states that are counteracting this, New York and California, by enacting laws that require employer provided health insurance plans to pay for birth control pills. There are many states that are considering changes in the law specifically because of the Viagra disparity.

What I find even more interesting is that cost of the pills. At one time, before state law, I had to pay out of pocket for OC. Just recently, there was a problem with the mail-order pharmacy, so I was going to be paying out-of-pocket for a prescription. The cost of the GENERIC prescription was now more expensive than the original name brand prescription from about 10 years before. When, in general, when a generic becomes available the prescription tends to become cheaper. Not the case in this instance.

http://socialissues.wiseto.com/Articles/183419558/
http://www.medicalnewstoday.com/articles/117556.php
http://www.nytimes.com/2006/10/20/nyregion/20courts.html?_r=2&oref=slogin

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April 19, 2009 10:30 PM
Let me start out by saying that I think that health insurance plans should cover birth control, but I am going to play devil's advocate.

I don't think the reasoning for why they don't is all that far fetched. The real issue is how birth control pills relate to health. I hope we can all agree that ED is a serious health issue that should be covered.

Birth control pills on the other hand are USUALLY used purely to prevent conception. So is a health insurance plan responsible for paying for you to prevent conception? Usually health insurance is only liable to help treat and prevent illness, and so unless pregnancy is classified as an illness, it is not unreasonable to think that birth control wouldn't be covered.

Now I must add an important clarification. When birth control is being used for something other than preventing conception it is a different matter. You mention it is used for treating polycystic ovaries, and I know that it has many other important uses. In these cases, the medication is being used to treat a health issue, and ABSOLUTELY should be covered by all health insurance plans.

So in summary, your argument that birth control pills are similar to viagra works whenever the birth control is treating an actual disease. However when birth control pill are being used only to prevent conception, they are really more comparable to condoms. Condoms are very important to health as they both prevent conception and STDs. However they are not covered by health insurance.

The idea that it is some sort of vast sexist plot or something of that manner is I little extreme. As with most debated issues, it is a subtle difference between the way different people view different things. Furthermore, saying that people with the opposite view are sexist or patriarchal doesn't really help advance your idea, especially when you don't even explain why you feel this way.

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April 19, 2009 10:41 PM
I was precisely looking for people to play devil's advocate and give me rational explanations as to why this exists.
My one gripe with this argument is that ED, while a real medical condition is not, to my knowledge, that serious or life threatening. It seems the treatment may be more dangerous than the condition itself. So if it's elective, why the coverage? It could be placed in the same category as cosmetic procedures and certain dermatological products.
I do agree completely that while not necessarily for elective use, it should be covered for medical conditions. I've been on the pill since I was a teenager for PCOS and it's really expensive but I really have no choice in the matter because if I get off my treatment I will be in pain, I will have irregular periods and worst of all I can sacrifice my ability to get pregnant in the future. Other examples of medical conditions treated by Oral BC are acne, endometriosis and PMDD.
I also think that the health benefits of birth control pills may outweigh the costs. Research shows it prevents certain forms of cancer.

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April 19, 2009 11:18 PM
First off let me say, great question.

I don't agree that that ED is not a serious condition. Certainly there may be situations in which it is less serious. However, in all seriousness, the inability to have sex, and the self confidence issues that go along with that, is very serious. (Haha how many times did I just use the word serious?)

Also it is true that ED isn't life threatening, but that is not a requirement for something to be covered by health insurance. Some mental health issues are not life threatening, neither is arthritis or a bad hip.

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April 19, 2009 11:20 PM
Good point. But I have to add that mental health conditions are life threatening --> Suicide and risk of violence.

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April 19, 2009 11:31 PM
You are right, I meant to say "some mental health issues" instead I typed "all mental health issues." Its fixed now, thanks for pointing that out.

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April 23, 2009 04:21 PM
I just wanted to say, that your insurance must really suck. My insurance covers contraceptives BUT not fertility drugs. So it must depend on your company.

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April 19, 2009 11:52 PM
Aetna PPO seemed to cover it the last time I tried..but the generic versions

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April 20, 2009 12:27 AM
Some companies do because it's the law or because it's part of the contract but there's no legally ordained parity in the US except in some states. So many companies just won't bother.

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